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March 25th, 2012 posted by Paul Rega, MD, FACEP March 25, 2012 @ 9:30 am

ER Docs & Spice

http://www.sci-tech-today.com/news/Fake-Marijuana-Confuses-ER-Docs/story.xhtml?story_id=110002BU06F6&full_skip=1

ER Docs Don’t Recognize Signs of ‘Spice’ in Teens

3/20/12

“K2,” “Spice” and “Blaze” are all names for synthetic marijuana, a dangerous substance whose growing use by teens is leading to an emergency room crisis. Still a relatively new drug, emergency room physicians may not recognize the drug’s symptoms, such as excessive sweating, agitation, inability to speak, aggression and restlessness. ….As federal lawmakers consider a bill to ban sales of synthetic marijuana, at least 39 states already have taken steps to do so, according to the National Conference of State Legislatures. This month, the federal Drug Enforcement Administration extended its ban on five chemicals used to make the drug. ……”



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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 7:51 am

chest pain, no known cardiac history, & normal EKG

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Short- and long-term cardiac events in patients with chest pain with or without known existing coronary disease presenting normal electrocardiogram
Published online: 19 March 2012
Alberto Conti, Claudio Poggioni, Gabriele Viviani, Margherita Luzzi, Sonia
Vicidomini, Maurizio Zanobetti, Francesca Innocenti, Riccardo Pini, Luigi
Padeletti, Gian Franco Gensini
DOI: 10.1016/j.ajem.2012.01.022
American Journal of Emergency Medicine, The, http://www.ajemjournal.com/article/S0735-6757%2812%2900048-4/abstract

One-third of patients with chest pain with known coronary disease, negative ECG, and biomarkers were subsequently found to have adverse cardiac events.



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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 7:45 am

Vorapaxar

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http://www.nejm.org/doi/full/10.1056/NEJMoa1200933

http://www.medpagetoday.com/MeetingCoverage/ACCMeeting/31800

By Todd Neale, Senior Staff Writer, MedPage Today

Published: March 24, 2012

CHICAGO — “An investigational thrombin receptor antagonist — vorapaxar — reduced ischemic events in patients with stable atherosclerotic disease, but increased bleeding, a large randomized trial showed.

The rate of cardiovascular death, MI, or stroke was 9.3% with vorapaxar and 10.5% with placebo (HR 0.87, 95% CI 0.80 to 0.94), according to David Morrow, MD, MPH, of Brigham and Women’s Hospital in Boston.

But the antiplatelet increased the rate of moderate or severe bleeding (4.2% versus 2.5%) and the rate of intracranial hemorrhage (1% versus 0.5%), Morrow reported at the American College of Cardiology meeting here. The results were published simultaneously online in the New England Journal of Medicine.

Combining the efficacy and safety outcomes yielded a neutral result for the net clinical outcome (HR 0.97, P=0.40)….”



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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 5:58 am

(Audio) The Historic Triangle Shirtwaist Fire, 3/25/1911

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This was recorded on 3/25/2011.



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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 5:50 am

Flu visits climbing slightly

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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 5:50 am

US Flu Map: Week 11

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March 25th, 2012 posted by Paul Rega, MD, FACEP @ 5:49 am

Campylobacter bacteria in raw cream……

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http://www.thecalifornian.com/article/20120323/NEWS01/120323008

The Californian, 3/23/12

CDFA announces recall of raw milk products from San Benito County farm

“Raw milk, raw nonfat milk and raw cream produced by Claravale Farm of San Benito County is the subject of a statewide recall and quarantine order announced today by California State Veterinarian Dr. Annette Whiteford. The quarantine order came following the confirmed detection of campylobacter bacteria in raw cream.

Consumers are strongly urged to dispose of any product remaining in their refrigerators with code dates of “MAR 27” and earlier, and retailers are to pull those products immediately from their shelves……”



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